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Assessment and Screening of Depression in Heart Failure Patients: Nurses' Knowledge and Barriers.

Creator

Nguyen, Jimmy, Graven, Lucinda

Abstract/Description

Purpose: Heart failure (HF) is a devastating, progressive disease. Many HF patients have undiagnosed depression, increasing mortality and hospital visits. Nurses and providers often fail to recognize depression in this population. Therefore, this project aimed to explore current nurse knowledge base regarding depression; identify barriers to depression screening in HF patients; and introduce two depression screening tools, the Center for Epidemiologic Studies Depression Scale (CES-D-3) and... Show morePurpose: Heart failure (HF) is a devastating, progressive disease. Many HF patients have undiagnosed depression, increasing mortality and hospital visits. Nurses and providers often fail to recognize depression in this population. Therefore, this project aimed to explore current nurse knowledge base regarding depression; identify barriers to depression screening in HF patients; and introduce two depression screening tools, the Center for Epidemiologic Studies Depression Scale (CES-D-3) and the Patient Health Questionnaire (PHQ-2). Methods: Using a quasi-experimental, pre/post design, an educational intervention was performed at a 300+ bed hospital, including a 15-minute educational intervention on depression and depression screening tools. Registered nurses completed a survey before (n = 51) and one month after (n = 31). Results: The sample was predominantly female (77%), 25-35 years old (67%), and cared for HF patients at least once a month (96%). The three largest barriers to depression screening reported included lack of time (100%), comfort level with patient (65%), and unsure how to assess (61%). Post-intervention, both nurses and patients responded better to the PHQ-2 versus the CES-D (77% versus 23%), with 74% of nurses using the tools at least once. This project observed a significant increase of comfort level and familiarity with depression (Z = -3.14, p < 0.04). Discussion: Although an improvement in comfort and familiarity with depression was noted, depression screens were not routinely used afterwards (74% used at least once). The intervention and/or the project duration may have been too short to notice a culture change. Conclusions: This project suggests that depression education can increase familiarity, comfort level, and knowledge of depression in nurses working with HF patients in acute care settings. The PHQ-2 may be a viable option to screening, given it was preferred over the CES-3, by both patient and nurses. Show less

Date Issued

2018-04-26

Identifier

FSU_libsubv1_scholarship_submission_1524801870_41be20a3

Format

Citation

Title

Dirac Cone in two dimensional bilayer graphene by intercalation with V, Nb, and Ta transition metals.

Creator

Pakhira, Srimanta, Lucht, Kevin P., Mendoza-Cortes, Jose L.

Abstract/Description

Bilayer graphene (BLG) is semiconductor whose band gap and properties can be tuned by various methods such as doping or applying gate voltage. Here, we show how to tune electronic properties of BLG by intercalation of transition metal (TM) atoms between two monolayer graphene (MLG) using a novel dispersion-corrected first-principle density functional theory approach. We intercalated V, Nb, and Ta atoms between two MLG. We found that the symmetry, the spin, and the concentration of TM atoms in... Show moreBilayer graphene (BLG) is semiconductor whose band gap and properties can be tuned by various methods such as doping or applying gate voltage. Here, we show how to tune electronic properties of BLG by intercalation of transition metal (TM) atoms between two monolayer graphene (MLG) using a novel dispersion-corrected first-principle density functional theory approach. We intercalated V, Nb, and Ta atoms between two MLG. We found that the symmetry, the spin, and the concentration of TM atoms in BLG-intercalated materials are the important parameters to control and to obtain a Dirac Cone in their band structures. Our study reveals that the BLG intercalated with one Vanadium (V) atom, BLG-1V, has a Dirac Cone at the K-point. In all the cases, the present DFT calculations show that the 2pz sub-shells of C atoms in graphene and the 3dyz sub-shells of the TM atoms provide the electron density near the Fermi level EF which controls the material properties. Thus, we show that out-of-plane atoms can influence in-plane electronic densities in BLG, and enumerate the conditions necessary to control the Dirac point. This study presents a new strategy for controlling the material properties of BLG so that they exhibit various behaviors, including: metal, semi-metal, and semiconductor by varying the concentration and spin arrangement of the TM atoms in BLG while offering insight into the physical properties of 2D BLG-intercalated materials. Show less

In this study, we examined the local dynamics of acidic fibroblast growth factor (FGF-1) as well as the binding sites of various polyanions including poly-sulfates (heparin and low MW heparin) and poly-phosphates (phytic acid and ATP) using hydrogen-deuterium exchange mass spectrometry (HX-MS). For local dynamics, results are analyzed at the peptide level as well as in terms of buried amides employing crystallographic B-factors and compared with a residue level heat map generated from HX-MS... Show moreIn this study, we examined the local dynamics of acidic fibroblast growth factor (FGF-1) as well as the binding sites of various polyanions including poly-sulfates (heparin and low MW heparin) and poly-phosphates (phytic acid and ATP) using hydrogen-deuterium exchange mass spectrometry (HX-MS). For local dynamics, results are analyzed at the peptide level as well as in terms of buried amides employing crystallographic B-factors and compared with a residue level heat map generated from HX-MS results. Results show that strand 4 and 5 and the turn between them to be the most flexible regions as was previously seen by NMR. On the other hand, the C-terminal strands 8, 9 and 10 appear to be more rigid which is also consistent with crystallographic B-factors as well as local dynamics studies conducted by NMR. Crystal structures of FGF-1 in complex with heparin have shown that heparin binds to N-terminal Asn18 and to C-terminal Lys105, Tryp107, Lys112, Lys113, Arg119, Pro121, Arg122, Gln127 and Lys128 indicating electrostatic forces as dominant interactions. Heparin binding as determined by HX-MS is consistent with crystallography data. Previous studies have also shown that other polyanions including low MW heparin, phytic acid and ATP dramatically increase the thermal stability of FGF-1. Using HX-MS, we find other poly anions tested bind in a similar manner to heparin, primarily targeting the turns in the lysine rich C-terminal region of FGF-1 along with two distinct N-terminal regions that contains lysines and arginines/ histidines. This confirms the interactions between FGF-1 and polyanions are primary directed by electrostatics. Show less

Date Issued

2018-04-05

Identifier

FSU_libsubv1_scholarship_submission_1523040928_8f170751

Format

Citation

Title

Long Acting Reversible Contraceptives: An Educational Tool to Improve Awareness.

Creator

Adams, Tracy, Greenhalgh, Jolynn

Abstract/Description

Purpose: The aim of this study was to increase awareness of contraceptive methods and measure the likelihood that participants request a more effective method, including long-acting reversible contraceptives (LARCs), than they are currently using. Methods: This project was a quazi-experimental, cross-sectional designed study. The intervention consisted of one-on-one time with an experienced family planning nurse using the Centers for Disease Control and Prevention (CDC) “Effectiveness of... Show morePurpose: The aim of this study was to increase awareness of contraceptive methods and measure the likelihood that participants request a more effective method, including long-acting reversible contraceptives (LARCs), than they are currently using. Methods: This project was a quazi-experimental, cross-sectional designed study. The intervention consisted of one-on-one time with an experienced family planning nurse using the Centers for Disease Control and Prevention (CDC) “Effectiveness of Family Planning Methods” handout as a teaching tool (CDC, 2017). A post-survey measured how likely women were to ask about more effective contraceptives including LARC. Results: Data was collected over a four day period, resulting in 17 participants. Six women (35.3%) were using no method. Post intervention, three (50%) stated they would talk with their practitioner about a more or most effective method of birth control. Three women were using a less effective method. One hundred percent of these women were likely to ask about most effective methods. Five participants (29.4%) were using a moderately effective method. Three of these five (60%) were interested in a most effective method. Three participants (17.6%) were already using a most effective method. Discussion: Nine of the 17 participants (52.9%) were likely to ask their practitioner about LARC. This demonstrates a positive correlation between contraceptive education and increased interest in LARC. Conclusion: LARC family planning methods, although proven safe and effective methods of birth control, are underutilized in the United States. When provided education on all available methods, women are better equipped to choose a method that not only fits their lifestyle, but also offers a high level of efficacy. More research with larger numbers of study participants is needed to determine best practices for improving LARC usage in the United States. Show less

Date Issued

2018-04-06

Identifier

FSU_libsubv1_scholarship_submission_1524061692_aea16f4e

Format

Citation

Title

Macros to Conduct Tests of Multimodality in SAS.

Creator

Neville, Zacharia, Brownstein, Naomi

Abstract/Description

The Dip Test of Unimodality and Silverman's Critical Bandwidth Test are two popular tests to determine if an unknown density contains more than one mode. While the tests can be easily run in R, they are not included in SAS software. We provide implementations of the Dip Test and Silverman Test as macros in the SAS software, capitalizing on the capability of SAS to execute R code internally. Descriptions of the macro parameters, installation steps, and sample macro calls are provided, along... Show moreThe Dip Test of Unimodality and Silverman's Critical Bandwidth Test are two popular tests to determine if an unknown density contains more than one mode. While the tests can be easily run in R, they are not included in SAS software. We provide implementations of the Dip Test and Silverman Test as macros in the SAS software, capitalizing on the capability of SAS to execute R code internally. Descriptions of the macro parameters, installation steps, and sample macro calls are provided, along with an appendix for troubleshooting. We illustrate the use of the macros on data simulated from one or more Gaussian distributions as well as on the famous iris dataset. Show less

Numerous experimental studies have found that teams outperform individuals on intellective problems by a large degree. This result is intuitively appealing, as teams can benefit from sharing insights. However, much of this literature considers a task that involves a single clear insight. We instead analyze experiments comparing the performance of individuals and teams of four subjects at solving a series of challenging logic puzzles, where the solution involves a series of incremental steps.... Show moreNumerous experimental studies have found that teams outperform individuals on intellective problems by a large degree. This result is intuitively appealing, as teams can benefit from sharing insights. However, much of this literature considers a task that involves a single clear insight. We instead analyze experiments comparing the performance of individuals and teams of four subjects at solving a series of challenging logic puzzles, where the solution involves a series of incremental steps. Contrary to the existing literature, team performance is statistically indistinguishable from that of individuals when there is no cost to sending a message. Frictions resulting from both congestion and incorrect suggestions substantially derail the solution process for teams. If we impose a very small cost of communication on teams, the performance of teams improves. Underlying these results is a robust negative relationship between frequency of communication and team performance. Using a straightforward prediction exercise, we show that performance would have improved dramatically if the best member of each team had been asked to solve the puzzles alone rather than forming a team. Show less